Autism and the allure of junk science

The Chicago Tribune’s new medical reporter Trine Tsouderos (my successor at the paper) has a must-read article in today’s Trib about misguided efforts to use the “chemical castration” drug Lupron as a treatment for young kids with autism. It’s part one in a two-part series, with contributions from an all-star cast including veteran national reporter Tim Jones and investigative reporters Patricia Callahan and Steve Mills.

I can’t say enough good things about the piece. It draws on an impressive array of endocrinologists and pediatricians who attest that the children being treated are not suitable for the testosterone-lowering drug. Bonus: They quote the brother of the actor who plays “Borat,” noted Cambridge University autism researcher Simon Baron-Cohen.

The father-and-son physician team who developed the suspect protocol claim that many experts back their approach, including Baron-Cohen – but Baron-Cohen delivers a stinging rebuke of their reliance on Lupron: “The idea of using it with vulnerable children with autism, who do not have a life-threatening disease and pose no danger to anyone, without a careful trial to determine the unwanted side effects or indeed any benefits, fills me with horror,” Baron-Cohen said. So much for that endorsement.

One of the best things about the piece that it gives both sides room to make their case without falling into a “he said/she said” routine, which would not reflect the consensus against using this therapy. Autism is a terrifying condition, but that doesn’t justify trying powerful treatments without evidence that they will work safely. These physicians claim to have seen some effect in patients, but that’s not surprising – any potent drug with psychiatric effects could influence a child’s behavior in the short term. The article indicates that the daily dose the doctors use for autism patients is 10 times the normal amount typically given for children with early puberty. With that kind of dosage I’d be surprised if there weren’t some psychiatric effect. But that doesn’t mean it’s the right effect, or that the drug is safe for children. Only a trial can determine that.

So kudos to Trine, and to the Tribune for giving these careful reporters the time and space to explain a difficult issue and a treatment that could put kids at risk. It’s a heartening sign during a gut-wrenching time for newspapers. I can’t wait for part two.